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Between 2009 and 2014, Kabul NATO role 3 hospital provided comprehensive medical services to NATO troops engaged in Afghanistan as well as care for Afghan national security forces and for Afghan and non-Afghan civilians. This study aims at describing the occurrence and the management of cardiovascular diseases in patients presenting to the emergency room or the outpatient clinic or hospitalized for a noncardiovascular reason over a 15-week-long period.The patients for whom cardiologic advice was sought between June 16th and October 1st, 2012, were prospectively included. Demographic and medical data were recorded for each patient. Statistical analysis was performed with Epi Info 3.5.1 software. For continuous variables, data are expressed as mean ± SD. Qualitative variables are expressed as percentages.Cardiologic advice was sought for 52 patients. The patients initially presenting for a cardiovascular reason were mainly non-Afghans; 34.2% of them were experiencing acute coronary syndromes, among whom 76.9% were civilians, working in Afghanistan for non-Afghan companies, and 30.8% had known cardiomyopathies or unexplored symptoms before leaving for Afghanistan. Most of them accumulated cardiovascular risk factors. Three patients among the four presenting with ST-segment elevation acute coronary syndromes presented serious complications (respectively, death, acute heart failure, and failed thrombolysis with no possibility to perform rescue percutaneous coronary intervention). Acute heart failure, acute pulmonary embolism and acute coronary syndrome were the most common reasons for seeking cardiologic advice about patients hospitalized for noncardiovascular diseases.Reasons for seeking cardiologic advice were diverse but acute coronary syndromes in frequently high-risk non-Afghan patients were the most frequent and serious ones. The lack of appropriate diagnostic and therapeutic means available within reasonable time resulted in serious complications for most patients presenting with ST-segment elevation myocardial infarction. Consequently a medical selection seems necessary for civilians sent to work in such conditions, as performed for military personnel. The management of Afghan patients was mainly limited by the lack of local medical infrastructure.

The main goal of the North Atlantic Treaty Organization role 3 hospital located in Kabul is to provide comprehensive medical services to troops engaged in Afghanistan. Nevertheless, it also provides care for Afghan National Security Forces and for Afghan and non-Afghan civilians.To describe the patients admitted to the conventional hospitalization unit over a 3-month period, between June 29 and October 1, 2012.A total of 439 patients were admitted, for scheduled surgery, discharged from intensive care unit, or referred by emergency room and primary care physicians. Causes of hospitalization were diverse, particularly for nonscheduled admissions, with mainly war- and traffic-accident-related injuries for Afghan civilians and national security forces, and non-war- and non-traffic-accident-related trauma emergencies and gastroenteritis for non-Afghan patients. Suspected or confirmed cardiovascular diseases were a frequent cause of hospitalization and the leading cause of medical evacuation out of war zone for non-Afghan civilians. The patients admitted for war injuries were mainly Afghan civilians, of whom 36.6% were children and 44.7% had been injured by improvised explosive devices.Reasons of admission to the conventional hospitalization unit were numerous. Care provided to Afghan and non-Afghan civilians represented the main activity of this unit.

International audience; Spondyloarthropathies are associated with a greater cardiovascular risk than expected based on the cardiac lesions known to occur in these diseases. The prevalence of several conventional risk factors is high in spondyloarthropathy patients, and chronic inflammation also contributes to premature plaque formation. In addition, susceptibility genes for spondyloarthropathies may be associated with an increased risk of cardiovascular disease. Finally, several drugs used to treat spondyloarthropathies may contribute to the occurrence of cardiovascular events. A careful evaluation of the cardiovascular risk profile is a key component of the management of patients with spondyloarthropathies.

Resume On objective au sein des spondylarthropathies une surmortalite cardiovasculaire que les atteintes cardiaques classiques n’expliquent pas. Il existe chez ces patients une prevalence accrue de certains facteurs de risque conventionnels et une inflammation chronique a l’origine d’une formation precoce de plaques d’atherome. Les patients atteints de spondylarthropathies presentent egalement un risque cardiovasculaire specifique lie probablement au terrain genetique. De plus, certaines therapeutiques ont pu etre incriminees dans la survenue d’evenements cardiovasculaires indesirables. L’evaluation: Du risque cardiovasculaire chez ces patients apparait donc opportune au cours de leur suivi.